1680J_
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY, OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS ',CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, 'parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: 3/4/93
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION CAI.LE TAMPICO RETWE.FN AVE. REEHIMAS & FISFN MIER
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION LOWER TELEPHONE CABLE AND
CONDUIT FOR NEW STORM DRAIN
DESCRIPTION OF CONSTRUCTION LOWER TELEPHONE
FACILITIES
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/10/93
APPROXIMATE TIME OF COMPLETION 5/14/93
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
r
In consideration of the granting of this permit, the applicant hereby agrees
Sketch (attach construction plans if appropriate)
CONTACT JIM HUNDLEY FOR ADDITIONAL
INFOMATION AT 142-0516 AND REFER
TO WORK ORDER 0543-9PO08MS93049
to:
SEE ATTACHED DRNWING
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the reresult of this work
J - Lf 1 7 7
Signature of Applicant or Ag nt
GTE CALIFORNIA INC 45-590 JACKSON ST INDIO CA 92201-4602 (619) 342-0536
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
r
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 0
Receipt No
Received by
Date
y
PERMIT VALIDATION
PERMIT NO. 1680
DATE APPROVED 3/6/93
EXPIRATION DATE 5/20/93
DATE ISSUED 3/4/93
By ShWQ_
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
Is
i
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
1993 Subdivision Improvement Permit — Class III
DATE: MARCH 3, Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION — CALLE TAMPICO BETWEEN AVENIDA BERMUDAS AND EISENHOWER
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION LOWER TELEPHONE CABLE AND
CONDUIT FOR NEW STORM DRAIN
DESCRIPTION OF CONSTRUCTION LOWER TELEPHONE
FAf'TI TTTF_
Sketch (attach construction plans if appropriate)
CONTACT JIM HUNDLEY FOR ADDITIONAL
INFORMATION AT 342-0516 AND REFER
TO WORK ORDER 0543-9PO08MS93049
DIMENSION OF INSTALLATION OR REMOVAL
SEE ATTACHED DRAWING
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/10/93
APPROXIMATE TIME OF COMPLETION 5/14/93
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) _
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
Penalties, Inabilities or loss resulting from claims or court action and arising out of any accident, lost or dame" to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify, the Administrative Authority at least twenty-four 1241 hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as ths(fft4it.of this worlq\
GTE CALIFORNIA, INC
Name of Applicant 1plesse print)
45-590 JACKSON STREET, IN
Name of Contractor and Job Foreman
Contractor's License No.
Applicant or (AWnt
CA 92201-4602
Business Address
Business Address
619/342-0536
Telephone No.
Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III --'--
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
'ermit Fee _
'enaity
:ash Deposit -Surety Bond
f required
TOTAL: $
ieceipt No.
Immived by Date
tecorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: 16191564.2246
it
0
A
FORM 90005660
R
2�-
.� =�